• A A Louizos, S J Hadzilia, E Leandros, I K Kouroukli, L G Georgiou, and J P Bramis.
• Anesthesia Department, Hippocration General Hospital, 108 Vas. Sofias Avenue, 11527, Athens, Greece. louizos@ath.forthnet.gr
• Surg Endosc. 2005 Nov 1;19(11):1503-6.

BackgroundThe aim of this study was to test the use of preincisional and intraperitoneal levobupivacaine (L-B) 0.25% in laparoscopic cholecystectomies for postoperative analgesia.MethodsA total of 108 patients under general anesthesia were randomly assigned to receive preincisional local infiltration of 20 ml solution and intraperitoneal instillation of another 20 ml solution. Group A received for local infiltration and intraperitoneal instillation normal saline (NS). Group B received for local infiltration L-B 0.25% and for intraperitoneal instillation NS. Group C received for local infiltration NS and for intraperitoneal instillation L-B 0.25%. Group D received both for local infiltration and intraperitoneal instillation L-B 0.25%. Abdominal and right shoulder pain were recorded for 24 h postoperatively.ResultsThe pain scores were lower in group D than in the other groups during rest, cough, and movement (p < 0.05). Rescue analgesic treatment was significantly lower in patients of group D (35%) as compared with that of group A (84%) (p < 0.05). The incidence of right shoulder pain was significantly lower in groups C (22%) and D (18%) than in any of the other groups (p < 0.05).ConclusionsThe combination of preincisional local infiltration and intraperitoneal instillation of L-B 0.25% shows an advantage for postoperative analgesia after laparoscopic cholecystectomy.

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